- Highmark Health (Pittsburgh, PA)
- …years with utilization review/ management + 1 year as a supervisor or manager of Utilization /Case Management with a Managed Care Organization + 1 year ... customers of Helion's technology platform(s). **ESSENTIAL RESPONSIBILITIES** + Perform management responsibilities to include, but are not limited to: involved… more
- CVS Health (Harrisburg, PA)
- …Health Counselor) Preferred Qualifications + Crisis intervention skills preferred managed care/ utilization review experience preferred + Case management and ... thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider… more
- Humana (Harrisburg, PA)
- …us put health first** This is a non-exempt position with responsibility for utilization management and clinical decision-making as outlined in the Autism Care ... Responsibilities** Tasks include, but are not limited to: **70%** : Performing utilization management activities for assigned areas. Ensures full compliance with… more
- St. Luke's University Health Network (Allentown, PA)
- …for admission and/or referral to appropriate level of care. + May assist in the utilization management of psychiatric cases in the absence of the utilization ... agencies, physicians, nursing staff, department managers, ancillary departments, and the Manager regarding variances, aspects of patient care management . +… more
- Guthrie (Sayre, PA)
- …staff, exhibiting the Core Values in all activities. Mentors under the Clinical Manager / Director and pursues management and leadership training within the ... / Director informed of clinical issues, triage problems, staffing issues, and risk management concerns. Acts on behalf of nurse Manager / Director in his/her… more
- St. Luke's University Health Network (Sellersville, PA)
- …in independent living skills of cooking, menu planning, grocery shopping, money management , cleaning, laundry, personal hygiene, etc. + Coach and or supervise ... to transportation policy. + Provide recovery-oriented counseling as evidenced by utilization of active listening skills and other motivational enhancement techniques… more
- Magellan Health Services (Bethlehem, PA)
- …collaboration with other members of the clinical team, authorizes and reviews utilization of autism services, including Applied Behavioral Analysis (ABA). ... of the members progress are ongoing. Assures overall case management with the inclusion of behavioral health...+ Maintains an active workload in accordance with Care Manager Performance Standards. + Works with community agencies as… more
- UPMC (Pittsburgh, PA)
- …of health insurance experience required. + 1 year of experience in clinical, utilization management , home care, discharge planning, and/or case management ... by the interdisciplinary team summarizing clinical and social history, healthcare resource utilization , case management interventions. Update the plan of care… more
- UPMC (Pittsburgh, PA)
- …of health insurance experience required. + 1 year of experience in clinical, utilization management , home care, discharge planning, and/or case management ... by the interdisciplinary team summarizing clinical and social history, healthcare resource utilization , case management interventions. Update the plan of care… more
- Highmark Health (Monroeville, PA)
- …effective resource utilization . Serves as key team members in the management of readmissions, length of stay, ED utilization , and patient/family ... or CERTIFICATIONS** **Required** + None **Preferred** + ACM Certification (Accredited Case Manager ) - American Case Management Association - American Case … more
- Universal Health Services (King Of Prussia, PA)
- …categories serving a total of 392 facilities, including: Acute Care, BH ( Behavioral Health), IPMs (Independent Physician Management ), Alt (Alternate) Sites and ... ranking of America's Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points,… more
- Lancaster General Health (Lancaster, PA)
- …Pennsylvania Board of Nursing. + Bachelor's degree in Nursing (BSN). + Knowledge of utilization review or managed care. + Care management experience in a managed ... **_Penn Medicine Lancaster General Health is recruiting for a full-time inpatient Case Manager to join a team of dedicated Case Managers managing a variety complex… more
- CenterWell (Harrisburg, PA)
- …Coordinate quality improvement activities to address high risk, high-utilizers/high-cost patient management through the utilization of the 5M's framework as ... ER visits, readmissions, total cost of care, and reducing acute care utilization ). * Familiarity in integrated care management programs with primary… more
- BriteLife Recovery (Hanover, PA)
- CASE MANAGER Do you work for a company that no longer aligns with your core values? Have you dreamt of working in a "true" team environment, where collaborating and ... most talented and caring, authentic individuals to create a world-class mission-centered behavioral health organization, focused on doing it the right way If you… more
- St. Luke's University Health Network (Sellersville, PA)
- …ability to pay for health care. The responsibilities of the Residential Care Manager are to plan, organize and implement an independent living skills program based ... and self-sufficiency in an independent living situation. The Residential Care Manager provides on-duty coverage and on-call overnight coverage as needed. This… more
- Highmark Health (Pittsburgh, PA)
- …is responsible for recommending and implementing strategic and comprehensive project management services in support of the corporation's business activities. The ... candidate must have extensive construction project management experience including coordination and facilitation of design, large...plans impact a portfolio >3 million SF. + Space Utilization /Key Metrics - supports the space standards and metrics… more
- Highmark Health (Pittsburgh, PA)
- …:** Date Posted: 20240228 Location: Allegheny General Hospital Department: Case Management , Emergency Department/CDU Status: Full Time Shift: 80 hours every two ... with overnight as needed, rotating weekends and holidays Union: Yes **CASE MANAGEMENT :** The Case Management Department at Allegheny General Hospital assists… more
- Centene Corporation (Harrisburg, PA)
- …healthcare environment Required 3+ years of experience in managed care, plus utilization management , care coordination, disease management , Medicare, ... on a regular basis.** **Position Purpose:** Functions as a program development manager in collaboration with Quality, Health Services and Operations business owners… more
- Ford Motor Company (Harrisburg, PA)
- …is best-in-class. **In this position ** The Accessories eCommerce Merchandising Manager is responsible for deeply understanding customer needs and optimizing the ... business value daily by pulling, analyzing, and translating web analytics and behavioral data into actionable insights to enhance sales, conversion, and customer… more
- UPMC (Pittsburgh, PA)
- UPMC's Western Psychiatric Hospital is in search of Discharge Plan Manager /Social Worker to join our Inpatient Social Work team! The Discharge Plan Manager (DPM) ... provided to help facilitate career growth! The Discharge Plan Manager functions as the coordinator and is accountable for...a focus on an optimal discharge plan with timely utilization of hospital resources. This optimal discharge plan reviews… more